title: Towards the 13-valent pneumococcal conjugate universal vaccination: effectiveness in the transition era between PCV7 and PCV13 in Italy, 2010-2013.
abstract: Pneumococcal disease epidemiology has changed after introduction of pneumococcal conjugate vaccines. Seven-valent vaccine (PCV7) has been effective in reducing invasive pneumococcal disease (IPD). In Europe, PCV13 effectiveness was estimated at 78% (95% CI: -18-96%) for 2-priming doses. In Italy, PCV7 was introduced in 2006 in the childhood immunization schedule and replaced with PCV13 in 2010. In Apulia, vaccination coverage has reached 95.1% (birth-cohort 2010). We estimated PCV program effectiveness and its impact on S. pneumoniae diseases. PCV EFFECTIVENESS: We used the screening method. We calculated the Proportion of Population Vaccinated from immunization registries and detected cases through a laboratory-confirmed surveillance among hospitalized children≤60 months. A confirmed IPD case was a child with PCR positive for S. pneumoniae. Differences among children were assessed with the Chi-square or the Fisher exact test (P value<0.05). PCV IMPACT: We constructed time series using outcome-specific Poisson regression models: hospitalization rate in pre-PCV era and hospitalization risk ratios (RRs) with 95% CIs for both PCV7 and PCV7/PCV13 shifting era. We calculated hospitalization RR with 95% CIs comparing pre-PCV years with vaccination period. The PCV effectiveness was 84.3% (95% CI: 84.0-84.6%). In May 2010-January 2013, we enrolled 159 suspected IPD of whom 4 were confirmed. Two (fully vaccinated) were caused by serotype 9V, 1 (not vaccinated) by serotype 3, 1 (vaccinated with 2 PCV13 doses) by 15B/C. The most important reduction was for pneumococcal pneumonia (RR: 0.43, 95% CI: 0.21-0.90). The PCV program show promising results in terms of both PCV13 effectiveness and its impact in reducing IPD in children<5 years.
authors.affiliation: Department of Medical and Surgical Sciences; University of Foggia; Foggia, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Martinelli
authors.affiliation: Department of Medical and Surgical Sciences; University of Foggia; Foggia, Italy.
authors.forename: Biagio
authors.initials: B
authors.lastname: Pedalino
authors.affiliation: Department of Biomedical Sciences and Human Oncology; University of Bari Aldo Moro; Bari, Italy.
authors.forename: Maria Giovanna
authors.initials: MG
authors.lastname: Cappelli
authors.affiliation: Prevention Department; Taranto Local Health Unit; Taranto, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Caputi
authors.affiliation: Department of Biomedical Sciences and Human Oncology; University of Bari Aldo Moro; Bari, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Sallustio
authors.affiliation: Department of Medical and Surgical Sciences; University of Foggia; Foggia, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Fortunato
authors.affiliation: Department of Biomedical Sciences and Human Oncology; University of Bari Aldo Moro; Bari, Italy.
authors.forename: Silvio
authors.initials: S
authors.lastname: Tafuri
authors.affiliation: Department of Medical and Surgical Sciences; University of Foggia; Foggia, Italy; European Programme for Intervention Epidemiology Training (EPIET); European Centre for Disease Prevention and Control (ECDC); Stockholm, Sweden.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Cozza
authors.affiliation: Department of Biomedical Sciences and Human Oncology; University of Bari Aldo Moro; Bari, Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Germinario
authors.affiliation: Department of Biomedical Sciences and Human Oncology; University of Bari Aldo Moro; Bari, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Chironna
authors.affiliation: Department of Medical and Surgical Sciences; University of Foggia; Foggia, Italy.
authors.forename: Rosa
authors.initials: R
authors.lastname: Prato
mesh_terms: D002675:Child, Preschool; D005260:Female; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D008297:Male; D011008:Pneumococcal Infections / Q000276:immunology* / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage* / Q000276:immunology*; D015995:Prevalence; D014611:Vaccination / Q000379:methods*
chemical_list: C538862:13-valent pneumococcal vaccine; D000069443:Heptavalent Pneumococcal Conjugate Vaccine; D022242:Pneumococcal Vaccines
keywords: hospitalization; pneumococcal conjugate vaccine; screening method; vaccine effectiveness; vaccine impact